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2024年欧洲心胸外科医师协会/欧洲心胸麻醉学会/欧洲心脏停搏与心肺复苏学会成人心脏手术体外循环指南分析

Analysis of 2024 EACTS/EACTAIC/EBCP Guidelines on Cardiopulmonary Bypass in Adult Cardiac Surgery.

作者信息

Ripoll Juan G, Bittner Edward A, Zaremba Solomiia, Nabzdyk Christoph S, Seelhammer Troy G, Wieruszewski Patrick M, Chang Marvin G, Ramakrishna Harish

机构信息

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.

Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA.

出版信息

J Cardiothorac Vasc Anesth. 2025 Mar 31. doi: 10.1053/j.jvca.2025.03.044.

Abstract

Cardiopulmonary bypass (CPB) in cardiac surgery involves the integration of multidisciplinary expertise, requiring collaboration among clinical perfusionists, surgeons, anesthesiologists, intensivists, and patients. This updated guideline, developed by the European Association for Cardio-Thoracic Surgery, the European Association for Cardiothoracic Anesthesia and Intensive Care, and the European Board of Cardiovascular Perfusion, incorporates the latest evidence to offer evidence-based recommendations for CPB. It expands on previous guidelines by addressing a broader range of CPB-related factors that impact patient outcomes. Although significant advances have been made in CPB technology and techniques, significant knowledge gaps remain. Bridging these gaps requires coordinated effort from all stakeholders in cardiac surgery, ensuring that future revisions of the guidelines are more comprehensive, practical, and applicable across various clinical settings. Ongoing improvements in CPB outcomes are contingent upon continued collaboration among cardiac surgeons, anesthesiologists, intensivists, and perfusionists, supported by specialized training programs in accredited institutions. These efforts aim to enhance patient safety, optimize CPB procedures, and improve overall cardiac surgery outcomes. This manuscript provides an overview of the key changes introduced in the new guidelines.

摘要

心脏手术中的体外循环(CPB)涉及多学科专业知识的整合,需要临床灌注师、外科医生、麻醉医生、重症监护医生和患者之间的协作。本更新指南由欧洲心胸外科学会、欧洲心胸麻醉与重症监护学会以及欧洲心血管灌注委员会制定,纳入了最新证据,为体外循环提供基于证据的建议。它通过涵盖更广泛的影响患者预后的体外循环相关因素,对先前的指南进行了扩展。尽管体外循环技术和方法已取得重大进展,但仍存在重大知识差距。弥合这些差距需要心脏手术所有利益相关者的协同努力,确保指南的未来修订更加全面、实用且适用于各种临床环境。体外循环预后的持续改善取决于心脏外科医生、麻醉医生、重症监护医生和灌注师之间的持续协作,并得到认可机构的专业培训计划的支持。这些努力旨在提高患者安全性、优化体外循环程序并改善整体心脏手术预后。本文提供了新指南中引入的关键变化概述。

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